WILDLIFE Youth - Pool Party!

Come on out to WILDLIFE this Wednesday as we hang out, have a BBQ, play Jump Dive, and have a good time in and around the pool! Please remember your swimsuit, a towel and a bag of chips or 2L of pop to share.

Electronic Permission Form

Pool Party Permission Form

Student Information

Student Name *

Student Name

First Name

Last Name

Student Phone

Student Phone

(###)

###

####

Student Email

Student Health Registration ID# *

Student Health Personal ID# *

Parent/Guardian Information

Parent/Guardian Name *

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Email *

Parent/Guardian Phone *

Parent/Guardian Phone

(###)

###

####

Parent/Guardian Address *

Parent/Guardian Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian Permission *

As a parent/legal guardian of the aforementioned student, I have reviewed the information about the “Pool Party” event, and give permission for the subject of this release to be involved in the overall activities. I have reviewed the rules of the activities and agree that the subject of this release will abide them. I also acknowledge that if the subject of the release has to return home early for discipline violations, it will be at my/our expense. I understand all reasonable safety precautions will be taken at all times by Soul Sanctuary and its agents during the events and activities. I authorize any treatment by an accredited hospital and/or physician deemed necessary for the subject of the release in case of an emergency. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Soul Sanctuary, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form.